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Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study.

ABSTRACT: BACKGROUND:The use of guided bone regeneration (GBR) for vertical and horizontal bone gain is a predictable approach to correct the bone defects before implant installation; however, the use of different protocols is associated with different clinical results. It is suggested that platelet-rich fibrin (PRF) could improve the outcomes of regenerative procedures. Thus, this study aimed to describe the bone gain associated with GBR procedures combining membranes, bone grafts, and PRF for vertical and horizontal bone augmentation. MATERIALS AND METHODS:Eighteen patients who needed vertical or horizontal bone regeneration before installing dental implants were included in the study. The horizontal bone defects were treated with a GBR protocol that includes the use of a mixture of particulate autogenous and xenogenous grafts in the proportion of 1:1, injectable form of PRF (i-PRF) to agglutinate the graft, an absorbable collagen membrane covering the regenerated region, and leukocyte PRF (L-PRF) membrane covering the GBR membrane. The vertical bone defects were treated with the same grafted mixture protected by a titanium-reinforced non-resorbable high-density polytetrafluoroethylene (d-PTFE-Ti) membrane and covered by L-PRF. The bone gain was measured using a cone-beam computed tomography at baseline and after a period of 7.5 (± 1.0) months. RESULTS:All patients underwent surgery to install implants after this regenerative protocol. The GBR produces an increase in bone thickness (p < 0.001) and height (p < 0.005) after treatment, with a bone gain of 5.9 ± 2.4 for horizontal defects and 5.6 ± 2.6 for vertical defects. In horizontal defects, the gain was higher in the maxilla than in mandible (p = 0.014) and in anterior than the posterior region (p = 0.033). No differences related to GBR location were observed in vertical defects (p > 0.05). CONCLUSION:GBR associated with a mixture of particulate autogenous and xenogenous grafts and i-PRF is effective for vertical and horizontal bone augmentation in maxillary and mandibular regions, permitting sufficient bone gain to future implant placement. TRIAL REGISTRATION:REBEC, RBR-3CSG3J . Date of registration-19 July 2019, retrospectively registered. http://www.ensaiosclinicos.gov.br/rg/RBR-3csg3j/.

SUBMITTER: Amaral Valladao CA

PROVIDER: S-EPMC7567776 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study.

Amaral Valladão Carlos Alberto CA Freitas Monteiro Mabelle M Joly Julio Cesar JC

International journal of implant dentistry 20201017 1

<h4>Background</h4>The use of guided bone regeneration (GBR) for vertical and horizontal bone gain is a predictable approach to correct the bone defects before implant installation; however, the use of different protocols is associated with different clinical results. It is suggested that platelet-rich fibrin (PRF) could improve the outcomes of regenerative procedures. Thus, this study aimed to describe the bone gain associated with GBR procedures combining membranes, bone grafts, and PRF for ve ...[more]

PMID: 33067730

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Project description:Objective: Recently, liquid platelet-rich fibrin (PRF), a rich source of concentrated platelets and growth factors, has emerged as a promising agent for stimulating tissue regeneration. However, its specific efficacy in chondrocyte proliferation and cartilage regeneration remains underexplored. To address this question, we investigated liquid PRF obtained through horizontal centrifugation and compared its effects with hyaluronic acid (HA), a high molecular weight glucosamine supplement widely used in clinical practice to safeguard against chondral damage. Materials and Methods: Liquid PRF, produced using horizontal centrifugation (liquid H-PRF) at 500 g for 8 min, served as our experimental agent. We conducted cell viability and proliferation assays using PRF-conditioned medium. We assessed the chondrocyte phenotype of ATDC5 cells through toluidine blue and alcian blue staining, real-time polymerase chain reaction (RT-PCR), Western blotting, and immunofluorescence staining. Furthermore, we examined the expression of genes involved in inflammation through RT-PCR and Western blot analysis. Results: Liquid H-PRF exerted notable effects on chondrocytes, influencing proliferation, inflammatory responses, and chondrogenic differentiation. The H-PRF group displayed significantly higher expression of chondrogenic markers, including Col2a1, compared to HA-treated cells, whereas aggrecan expression was significantly higher in the HA group. PRF also demonstrated the ability to reduce inflammatory levels in chondrogenic ATDC5 cells, and this effect was further enhanced when PRF from the buffy coat zone was added. In comparison, chondrocytes cultured in the HA group produced significantly fewer inflammatory factors than those in the PRF group, as confirmed qualitatively by Western blot analysis. Conclusion: Liquid H-PRF emerged as a potent stimulator for chondrogenesis and a regulator of the inflammatory response, achieving levels similar to HA. Moreover, liquid H-PRF exhibited strong potential for enhancing the production of cartilage extracellular matrix and promoting chondrogenic regeneration with notably increased Col2a1 levels. Future research should encompass animal studies and human trials to further evaluate the comparative effectiveness of liquid PRF versus HA, potentially as an alternative or complementary strategy for future clinical applications.

Project description:BackgroundDifferent techniques and materials such as bone grafts and bioactive agents have been used for alveolar ridge augmentation in extraction sockets with a defective wall, there is not a specific material or technique that has resulted in superior outcomes or prevented total bone loss.ObjectivesThis clinical study aims to evaluate radiographically the effectiveness of using bovine xenograft with platelet-rich fibrin (PRF) membrane on vertical and horizontal alveolar ridge dimensional changes following tooth extraction that are complicated by buccal bone loss.Materials and methodsThis study was conducted in Egypt on fourteen patients with a single posterior tooth indicated for extraction. A preoperative cone-beam computed tomography (CBCT) scan confirmed more than 50% loss in buccal bone in each tooth. Extraction sockets were packed with minced PRF clots mixed with a bovine xenograft. Each extraction socket was sealed by PRF membranes. CBCT scans, performed before tooth extraction and after 6 months, were used to assess alveolar ridge changes both vertically and horizontally.ResultsThere was a significant gain in the buccal and middle of the extraction socket bone height, recording 86.01% (6.33 mm) and 206.45% (9.6 mm), respectively. There was an insignificant bone loss in the lingual bone height and width, recording - 8.49% (-1.06 mm) and - 13.39% (1.05 mm), respectively. The results also showed a non-significant decrease in alveolar bone density (-14.06%) between pre-operative bone present apical to the extraction socket and newly formed bone inside the socket.ConclusionsRidge preservation/augmentation techniques using a bone graft mixed with PRF and covered by PRF membranes in fresh extraction sockets complicated by the loss of buccal bone result in buccal bone augmentation and a reduction in horizontal and vertical ridge collapse after tooth extraction.Clinical relevanceThe bovine xenograft in conjunction with PRF can be used immediately after extraction for ridge preservation, providing adequate bone width and height for implant placement.

Dataset Information

Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study.

Publications

Guided bone regeneration in staged vertical and horizontal bone augmentation using platelet-rich fibrin associated with bone grafts: a retrospective clinical study.

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